OBJECTIVE: To compare the rate of progression of de novo lesion between the cardiac rehabilitation (CR) and control groups. METHODS: This is a retrospective observational study. Patients who received drug-eluting stent (DES) due to acute coronary syndrome were included as subjects. The CR group received eight weeks of early CR program, and sustained a self-exercise program in the homes. The control group was instructed to exercise independently. Nine months after the first insertion of DES, we implemented follow-up coronary angiography, and compared the rate of progression of de novo lesion by quantitative angiographic measurement between the two groups. RESULTS: A total of 81 patients were recruited as subjects to CR group (n=32) or control group (n=49). At nine months, late luminal loss was 0.04+/-0.23 mm in the CR group and 0.00+/-0.31 mm in the control group (p=0.54, observed power=0.10). Late loss was -0.90%+/-9.53% in the CR group and 0.80%+/-11.15% in the control group (p=0.58, observed power=0.05). No target lesion revascularization procedures were needed in the CR group, while two in the control group (p=0.25). In the CR group, mean VO2max was significantly improved from 24.36+/-5.00 to 27.68+/-5.24 mL/kg/min (p<0.001). CONCLUSION: We could not observe a statistically significant difference in the progression rate of de novo lesion between the CR and control groups. Thus the current amount of nine months exercise-based CR program does not seem to have a distinct impact on the retardation of de novo coronary lesion in patients who received percutaneous coronary intervention with DES.
Acute Coronary Syndrome ; Coronary Angiography ; Coronary Stenosis ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Observational Study ; Percutaneous Coronary Intervention ; Phenobarbital ; Rehabilitation* ; Retrospective Studies ; Stents*

OBJECTIVE: To compare the rate of progression of de novo lesion between the cardiac rehabilitation (CR) and control groups. METHODS: This is a retrospective observational study. Patients who received drug-eluting stent (DES) due to acute coronary syndrome were included as subjects. The CR group received eight weeks of early CR program, and sustained a self-exercise program in the homes. The control group was instructed to exercise independently. Nine months after the first insertion of DES, we implemented follow-up coronary angiography, and compared the rate of progression of de novo lesion by quantitative angiographic measurement between the two groups. RESULTS: A total of 81 patients were recruited as subjects to CR group (n=32) or control group (n=49). At nine months, late luminal loss was 0.04+/-0.23 mm in the CR group and 0.00+/-0.31 mm in the control group (p=0.54, observed power=0.10). Late loss was -0.90%+/-9.53% in the CR group and 0.80%+/-11.15% in the control group (p=0.58, observed power=0.05). No target lesion revascularization procedures were needed in the CR group, while two in the control group (p=0.25). In the CR group, mean VO2max was significantly improved from 24.36+/-5.00 to 27.68+/-5.24 mL/kg/min (p<0.001). CONCLUSION: We could not observe a statistically significant difference in the progression rate of de novo lesion between the CR and control groups. Thus the current amount of nine months exercise-based CR program does not seem to have a distinct impact on the retardation of de novo coronary lesion in patients who received percutaneous coronary intervention with DES.
Acute Coronary Syndrome ; Coronary Angiography ; Coronary Stenosis ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Observational Study ; Percutaneous Coronary Intervention ; Phenobarbital ; Rehabilitation* ; Retrospective Studies ; Stents*

OBJECTIVES: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI).SUMMARY OF LITERATURE REVIEW: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. MATERIALS AND METHODS: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a 2.0×0.5 cm elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. RESULTS: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. CONCLUSION Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

STUDY DESIGN: Case report. OBJECTIVES: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). SUMMARY OF LITERATURE REVIEW: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. MATERIALS AND METHODS: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a 2.0×0.5 cm elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. RESULTS: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. CONCLUSION: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.
Back Pain ; Diagnosis ; Diagnosis, Differential ; Epidural Neoplasms ; Female ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Neurologic Manifestations ; Prognosis ; Recurrence ; Sensation ; Spine ; Thigh ; Thoracic Vertebrae

Decompression sickness is a disease caused by nitrogen bubbles in the tissues of divers who move too rapidly from environments of higher to those of lower atmospheric pressures. Nitrogen breathed in air under pressure dissolves in tissue fluids. When ambient pressure is reduced too rapidly, nitrogen goes out of solution faster than it can be circulated to the lungs for expiration. Gaseous nitrogen then accumulates in the joint spaces and peripheral circulation, impairing tissue oxygenation. We report a case of patient who experiencedneurogenic bladder and erectile dysfunction after decompression sickness. To our knowledge, this is the first case of neurogenic bladder and erectile dysfunction due to decompression sickness in the Korean literature.
Atmospheric Pressure ; Decompression Sickness* ; Decompression* ; Erectile Dysfunction* ; Humans ; Joints ; Lung ; Male ; Nitrogen ; Oxygen ; Urinary Bladder ; Urinary Bladder, Neurogenic*

BACKGROUND: Brain natriuretic peptide (BNP) is expected to play a role in hemodynamic modulation. Its biologically inactive fragment, the 76-amino-acid N-terminal proBNP (NT-pro-BNP), was known as one of the biologic markers of congestive heart failure and other clinical situations. But, there are controversies about clinical significance of NT-pro-BNP in ischemic stroke. This study was performed to find the clinical significance of NT- pro-BNP in early stage of acute ischemic stroke. METHODS: NT-pro-BNP levels were measured in 610 consecutive patients who admitted to the department of neurology at Chonnam National University Hospital. 205 patients were excluded due to incomplete follow-up period (more than 2 weeks), systemic infection, and etc. 286 ischemic stroke patients and 119 patients as control subjects were enrolled. NT-pro-BNP levels between stroke group and control were analyzed. When the patients in stroke group had more than 300 pg/mL of NT-pro-BNP, they were regarded as high group and the others were low group. National Institute of Health Stroke Scale (NIHSS) was checked at admission and 2 weeks later. Relationship between changes of NIHSS and the NT-pro-BNP level was also investigated. RESULTS: The NT-pro-BNP levels were significantly increased in ischemic stroke patients (830.87 pg/mL) compared with control group (378.27 pg/mL) (p=0.002). And the high levels of NT-pro-BNP in stroke patients were related to severity on admission and cardioembolic infarction. But there was no correlation between NT-pro-BNP and improvement of NIHSS. CONCLUSIONS: In this study, significant relationship between the severity of ischemic stroke and NT-pro-BNP was found. But NT-pro-BNP was not related to early prognosis of ischemic stroke.
Biomarkers ; Follow-Up Studies ; Heart Failure ; Hemodynamics ; Humans ; Infarction ; Jeollanam-do ; Natriuretic Peptide, Brain ; Neurology ; Prognosis ; Stroke*

Metabolomics has been used as a powerful tool for the analysis and quality assessment of the natural product (NP)-derived medicines. It is increasingly being used in the quality control and standardization of NP-derived medicines because they are composed of hundreds of natural compounds. The most common techniques that are used in metabolomics consist of NMR, GC-MS, and LC-MS in combination with multivariate statistical analyses including principal components analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Currently, the quality control of the NP-derived medicines is usually conducted using HPLC and is specified by one or two indicators. To create a superior quality control framework and avoid adulterated drugs, it is necessary to be able to determine and establish standards based on multiple ingredients using metabolic profiling and fingerprinting. Therefore, the application of various analytical tools in the quality control of NP-derived medicines forms the major part of this review. Veregen® (Medigene AG, Planegg/Martinsried, Germany), which is the first botanical prescription drug approved by US Food and Drug Administration, is reviewed as an example that will hopefully provide future directions and perspectives on metabolomics technologies available for the quality control of NP-derived medicines.
Chromatography, High Pressure Liquid ; Dermatoglyphics ; Metabolomics* ; Prescriptions ; Quality Control* ; United States Food and Drug Administration

Lemierre's syndrome is characterized by anaerobic bacterial infection in the head and neck, causing thrombophlebitis of the jugular vein. This disease is usually associated with a history of pharyngitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Lemierre's syndrome is seen most commonly in teenagers and young adults. We present a case report of a 67-year-old man with an atypical clinical manifestation of an uncommon pathogen in Lemierre's syndrome with epilepsia partialis continua.
Adolescent ; Aged ; Bacterial Infections ; Epilepsia Partialis Continua ; Fusobacterium ; Fusobacterium necrophorum ; Head ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Neck ; Pharyngitis ; Thrombophlebitis ; Venous Thrombosis ; Young Adult

In cases of atherosclerotic occlusion of coronary artery, is it appropriate to conclude that myocardial infarction is the true cause of death? More sensitive and specific diagnostic methods for the postmortem diagnosis of myocardial infarction are sometimes necessary because macroscopic or microscopic changes associated with early-phase acute myocardial injuries or myocardial infarct are sometimes absent in sudden cardiac death. Postmortem biochemical assessment of cardiac markers may help to evaluate the pathological cardiac status in sudden unexpected death without obvious cause. However, forensic pathologists are generally interested only in the macroscopic and microscopic findings for postmortem diagnosis of myocardial diseases and hesitate to use postmortem biochemical data because of the risk of postmortem changes. There are several clinically useful cardiac markers antemortem cardiac events such as myocardial injuries, infarct, or heart failure and postmortem data on cardiac markers in autopsy cases of sudden death have been reported. This review of postmortem data on cardiac markers in blood, other body fluids, and myocardial tissue will serve to introduce the recent international research trends and provide a foundation for a new field in postmortem biochemistry.
Autopsy ; Biochemistry ; Body Fluids ; Cardiomyopathies ; Coronary Vessels ; Death, Sudden ; Heart Failure ; Myocardial Infarction

PURPOSE: In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants. METHODS: We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records. RESULTS: Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032). CONCLUSION: NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.
Academic Medical Centers ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Medical Records ; Multivariate Analysis ; Parturition ; Retrospective Studies ; Risk Factors* ; Seoul ; Sepsis ; Ultrasonography